目的 探讨血清白蛋白(albumin,ALB)水平、新生儿急性生理评分(score for neonatal acute physiology with perinatal extension,SNAPPE)-Ⅱ对早产儿感染病情及预后的预测价值.方法 回顾性选择感染早产儿为感染组(n=46)、同期无感染者为对照组(n=36).比较并分析ALB、SNAPPE-Ⅱ及二者联合对预测两组早产儿感染的价值.结果 两组住院时间、吸氧时间、机械通气时间、无创正压通气时间以及静脉营养时间差异显著(P＜0.05).两组ALB、SNAPPE-Ⅱ差异均有统计学意义(P＜0.05).多因素非条件logistic分析结果显示,住院时间、吸氧时间、机械通气时间、无创正压通气时间、静脉营养时间及SNAPPE-Ⅱ是早产儿感染发生的独立危险因素(P＜0.05),ALB水平是早产儿感染发生的独立保护因素(P＜0.05).SNAPPE-Ⅱ对早产儿感染进行受试者工作特征曲线分析,ALB、SNAPPE-Ⅱ及二者联合诊断早产儿感染曲下面积分别为0.761、0.738、0.893,二者联合效能最高.结论 血清ALB、SNAPPE-Ⅱ对早产儿感染预后诊断均具有较佳价值,且二者联合效果更好,可帮助指导合理、及时进行抗菌药物治疗,改善预后.
Predictive value of serum albumin combined with SNAPPE-Ⅱ in infection and prognosis of premature infants
Objective To investigate the predictive value of serum albumin(ALB)level and score for neonatal acute physiology with perinatal extension(SNAPPE)-Ⅱ in infection and prognosis of premature infants.Methods The infected premature infants were selected as the infected group(n=46)and the control group without infected infants(n=36).The value of ALB,SNAPPE-Ⅱ and their combination in predicting the infection of preterm infants in two groups were compared and analyzed.Results There were significant differences in hospitalization time,oxygen inhalation time,mechanical ventilation time,non-invasive positive pressure ventilation time,and intravenous nutrition time between the two groups(P＜0.05).The differences in ALB and SNAPPE-Ⅱ between the two groups were statistically significant(P＜0.05).The results of multivariate unconditional logistic analysis showed that hospitalization time,oxygen inhalation time,mechanical ventilation time,non-invasive positive pressure ventilation time,intravenous nutrition time,and SNAPPE-Ⅱ were independent risk factors for premature infant infection(P＜0.05),and ALB level was an independent protective factor for premature infant infection(P＜0.05).receiver operating characteristic curve analysis of SNAPPE-Ⅱfor premature infant infection showed that the area under the curve of ALB,SNAPPE-Ⅱ,and their combination for diagnosing premature infant infection were 0.761,0.738,and 0.893,respectively,the combination of the two showed the highest efficacy.Conclusion Serum ALB and SNAPPE-Ⅱ have better value in prognosis diagnosis of infection in premature infants,and their combined effect is better,which can guide rational and timely antimicrobial therapy and improve prognosis.
serum albuminscore for neonatal acute physiology with perinatal extension-Ⅱinfection of premature infantpredictive value
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